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What causes recurrent pain in leg when diagnosed with chronic typhoid infection?

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Posted on Tue, 29 Dec 2015
Question: I was diagnosed as a Salmonella Typhoid carrier this year (I never remember having Typhoid Fever, but my mom became ill with it when she was in Brazil for business about 10 years ago). The doctors assume I became ill from her, as I am positive for Salmonella O Type Vi.

I have horrible leg pain that comes and goes. It hurts in my knees, heels, ankles, calves and thighs. The pain seems to get worse when I am laying down at night.

Could the chronic Typhoid infection be the cause of this recurring leg pain? My doctors do not seem too familiar with the symptoms of a chronic Typhoid infection other than gallbladder pain.
doctor
Answered by Dr. Muhammad Hanif (2 hours later)
Brief Answer:
Yes, it may be the cause of your symptoms !

Detailed Answer:
Thanks for consulting and your trust in HCM means a lot to me as a Physician.
I have completely reviewed your health query, and well realize all those concerns. Being your physician, I will take care all of them today and will extend my expertise to solve the problems.


Answer to your main query:-
Yes your symptoms may be due to the Typhoid infection you got in the past. Some patients with the same symptoms as you have also get constipation as a cause of concern and this is a common manifestation of the disease.

What necessary steps to be taken ahead:-
If I was your treating physician I would have prescribed you with Bactrim DS antibiotic if not allergic to Plus Ibuprofen and Omeprazole. You may ask your treating physician for a prescription of the medications. Take plenty of water and fruit juices. You should take Pedialyte Oral Rehydration Solution to keep the body hydrated and keep a balance of fluid and electrolytes. This type of pain issues are due to the muscle cramps due to fluid and electrolyte imbalances.
Stretching exercises of the legs will help you a lot. Physical therapy is the best option in such a situation that leads to resolution of the symptoms at large.

Yes, you should follow the instructions of your surgeon regarding your gallbladder issues.

Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you. Please don't forget to give 'Five star rating' (if agreed) to help me assist patients in a better way; and, please don't forget to click on 'Close This Discussion'.
For any disease you have, a timely follow-up is necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Muhammad Hanif (59 minutes later)
Dr. Hanif,

Thanks so much! I will ask him about the Bactrim.

However, my doctor already tested my electrolytes and said they were okay. Is it possible that the Typhoid bacteria could be penetrating my joints, causing pain? The pain worsens when I drink alcohol...

Regards,
XXXXXXX
doctor
Answered by Dr. Muhammad Hanif (1 hour later)
Brief Answer:
Yes Salmonella bacteria circulates in bloodstream and may cause it !

Detailed Answer:
Thanks for a follow up query. I am glad to answer your concerns.

Yes, the pathogens Salmonella and its other family members causing infection generally penetrate and circulate in blood. It reaches everywhere and very commonly forms abscesses anywhere in body.

Coming to your main question, yes it causes typically Osteomyelitis (bone infection most of the times in legs, arms and even the spine) and bone and joint pains (we name it arthralgia).

It is good to know that you will discuss the treatment options with your treating Physician.

Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you. Please don't forget to give 'Five star rating' (if agreed) to help me assist patients in a better way; and, please don't forget to click on 'Close This Discussion'.
For any disease you have, a timely follow-up is necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Muhammad Hanif (7 hours later)
Doctor,

Thank you very much.

Do you think with gallbladder removal, followed up with a heavy antibiotic treatment it could be possible to remove the Salmonella Typhoid bacteria all together? Or will I suffer this chronic pain for the rest of my life?

Thank you, XXXXXXX
doctor
Answered by Dr. Muhammad Hanif (3 hours later)
Brief Answer:
Repalse of the disease is is not so common (10% chances overall)!!!

Detailed Answer:
Thanks for consulting and your trust in HCM means a lot to me as a Physician. I appreciate your follow up query.

Gallbladder removal is just one part of the treatment. Gallbladder removal is necessary as this has became painful and once painful it's better to remove it surgically.

We have to administer medications to eradicate. I have seen good response if given Bactrim DS and also Quinolone class of antibiotics which have shown a less relapse in patients after antibiotics. But you need to remain in touch for medical help regarding leg pains (if there is any relapse). I pray for the best of your health.

Relapse of the disease is possible as it is not a disease which once happens and person becomes immune as in some disease it is the case. But with medications we may treat again and for salmonella typhi and its cousin bacteria there is no to least antibiotic resistance seen up til now. Once gallbladder removed you will not get this pain again in this area. Also relapse of typhoid fever is never so severe an illness as it was primarily before treatment.

Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you. Please don't forget to give 'Five star rating' (if agreed) to help me assist patients in a better way; and, please don't forget to click on 'Close This Discussion'.
For any disease you have, a timely follow-up is necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time).


Regards!
DR. HANIF
USA

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Answered by
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Dr. Muhammad Hanif

General & Family Physician

Practicing since :2009

Answered : 2369 Questions

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What causes recurrent pain in leg when diagnosed with chronic typhoid infection?

Brief Answer: Yes, it may be the cause of your symptoms ! Detailed Answer: Thanks for consulting and your trust in HCM means a lot to me as a Physician. I have completely reviewed your health query, and well realize all those concerns. Being your physician, I will take care all of them today and will extend my expertise to solve the problems. Answer to your main query:- Yes your symptoms may be due to the Typhoid infection you got in the past. Some patients with the same symptoms as you have also get constipation as a cause of concern and this is a common manifestation of the disease. What necessary steps to be taken ahead:- If I was your treating physician I would have prescribed you with Bactrim DS antibiotic if not allergic to Plus Ibuprofen and Omeprazole. You may ask your treating physician for a prescription of the medications. Take plenty of water and fruit juices. You should take Pedialyte Oral Rehydration Solution to keep the body hydrated and keep a balance of fluid and electrolytes. This type of pain issues are due to the muscle cramps due to fluid and electrolyte imbalances. Stretching exercises of the legs will help you a lot. Physical therapy is the best option in such a situation that leads to resolution of the symptoms at large. Yes, you should follow the instructions of your surgeon regarding your gallbladder issues. Hope I answered all of your queries. Let me know if you have further clinical concerns or doubts. I will be more than happy to get back to you. Please don't forget to give 'Five star rating' (if agreed) to help me assist patients in a better way; and, please don't forget to click on 'Close This Discussion'. For any disease you have, a timely follow-up is necessary regarding the treatment efficacy and to see if there is a need to change the treatment options. So keep a follow up to see how you doing (Always write down my name in start of your questions at this forum & I will be with you in no time). Regards! DR. HANIF USA